About Conduct Disorder

Introduction

The child with a Conduct Disorder does not respect authority, has little regard for the basic rights of others and breaks major societal rules; he or she demonstrates aggressive conduct that threatens physical harm or property damage, deceitfulness, theft, truancy or running away from home. The child with a Conduct Disorder is often vengeful, irascible, and has a chip on his shoulder. The cause of Conduct Disorder is believed to be a combination of genetic vulnerability and environmental factors. Treatment plans might include behavior therapy with the child and parents and pharmacotherapy.

Real Life Stories

Brandon's teachers in the daycare center report that he is the "terrorist of the 4- year-olds." He punches or bites children and pushes them off the swings in the playground without provocation. He swings the class pet rabbit by the tail in spite of being told how it hurts the animal. His parents report that he has been difficult to manage since he was an infant.

Eleven-year-old Paul, known as The Prankster in his family, was suspended from school after leaving half-eaten candy bars in all the girls' lockers. He had previously been suspended for leaving poison pills for the frogs in the biology class lab.

Robin, l6: "When I was 13, that summer was a blast. One time we picked up some older guys in a bar and tried a new kind of speed. We got really wild and we smashed in some car windows and somebody called the police. My mother freaked out and tried to punish me by locking me in my room, but I would just skip out on her through the window."

What are the symptoms?

A child or adolescent who has a Conduct Disorder behaves in a manner that violates the basic rights of others and/or major age-appropriate societal rules. These behaviors fall into four main groupings:

• aggressive conduct that causes or threatens physical harm to other people or animals. Examples of such behaviors are bullying or intimidating behavior, physical fights or cruelty, use of a weapon, forcing someone into sexual activity
• conduct that causes property loss or damage, such as firesetting, vandalism
• deceitfulness or theft, such as breaking into stores or homes, shoplifting
• serious violations of rules, such as truancy or repeated running away overnight

The behavioral disturbances can cause deficits in social, academic or occupational functioning. The behavior usually occurs in a variety of settings, such as home, school and community.

Other manifestations of Conduct Disorder:

• Oppositional Defiant Disorder (ODD) - a recurrent pattern of negativistic, defiant, disobedient and hostile behavior toward authority figures that persists for at least six months. To warrant a diagnosis of ODD, the child must show frequent occurrence of at least four behaviors such as losing temper, arguing with and defying adults, deliberately doing things that will annoy other people. Children and adolescents with ODD are usually angry and resentful and quick to blame others for their misbehaviors.

Who is likely to have it?

The age of onset of CD is critical. The earlier the age of onset the worse the prognosis.